MARIELLE TAVARES
NPI 1376282475
Nurse Practitioner - Family in Los Angeles, CA
About Marielle Tavares NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARIELLE TAVARES (NPI 1376282475) is an individual family provider in Los Angeles, California, licensed in California (95020541) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and is a graduate of University Of Southern California Keck School Of Medicine (2021).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Marielle Tavares is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
3Medicare enrollment records show Marielle Tavares reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Los Angeles, CA 90012
- Reassigned Medicare billing, California enrollment
- 60 clinicians in this Medicare group
Los Angeles, CA 90033
- Reassigned Medicare billing, California enrollment
- 88 clinicians in this Medicare group
Gardena, CA 90248
- Reassigned Medicare billing, California enrollment
- 375 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90048 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Marielle Tavares's NPI number?
The NPI number for Marielle Tavares is 1376282475. It was assigned to this individual provider in the NPPES registry on May 27, 2022.
Where is Marielle Tavares located?
Marielle Tavares practices at 6230 Wilshire Blvd Ste A, Los Angeles, CA 90048. The listed phone number is (877) 515-8113.
What is Marielle Tavares's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Marielle Tavares enrolled in Medicare?
Yes. Marielle Tavares is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Marielle Tavares's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Marielle Tavares reassigns Medicare benefits to 3 organizations: Los Angeles County Department Of Public Health (Los Angeles, CA), Complete Care Community Health Center, Inc (Los Angeles, CA) and Ehab Yacoub MD Inc. (Gardena, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Marielle Tavares's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Marielle Tavares was last updated on October 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Marielle Tavares · NPI 1376282475
Family physician in Los Angeles, California. Individual provider, active in the CMS NPPES registry since May 27, 2022.
## Identity
- **NPI:** 1376282475 (Entity type: Individual)
- **Enumerated:** May 27, 2022
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95020541 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 6230 WILSHIRE BLVD STE A, Los Angeles, CA 90048-5126
- **Phone:** (877) 515-8113
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Los Angeles County Department Of Public Health (NPI 1962109033, Los Angeles, CA); Complete Care Community Health Center, Inc (NPI 1215113964, Los Angeles, CA); Ehab Yacoub MD Inc. (NPI 1417373713, Gardena, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Southern California Keck School Of Medicine, class of 2021
## Record status
- **NPPES last updated:** October 20, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1376282475) · Data from the CMS NPPES public registry.